It’s a pleasure to rise today to speak to Bill 135, Convenient Care at Home Act. The Ontario NDP caucus will not be supporting this piece of legislation. I’ve been speaking with folks in my riding of Niagara Centre, and it’s clear our health care and home care system is broken. We have another health care bill from this government that fails to address the crucial issues impacting our home and health care services. This bill fails to provide any measures that will recruit the health human resource workforce we desperately need to sustain our health care system. The bill fails to prevent private companies from taking over public home care services—or have any accountability structure.

Bill 175, Connecting People to Home and Community Care Act, repealed the Home Care and Community Services Act. Bill 175 opened the door to the privatization of home and community care services by allowing services to be administered by Ontario Health instead of the Ministry of Health.

This bill creates an arm’s-length agency to oversee home care, with board-of-directors members appointed by the government. They can easily make decisions that further privatize our home care.

A few weeks ago, I was joined by thousands of people, on the front lawn of Queen’s Park, who fully reject any attempt by this government to further privatize their health care services. I was joined by countless folks from across Ontario, including the Niagara region and organizations like the Niagara Health Coalition, SEIU, Unifor, CUPE, and many others.

Rabble reported that Peter Groves, a Hamilton Health Coalition member, said, “The system” this government “is implementing isn’t working. A lot of home care is being privatized. When not-for-profit contracts are up for renewal, more and more are not being renewed....

“We have to get enough people stepping forward saying the system isn’t working. Doug Ford, you’re making it worse, not better.”

The article goes on to say, “Private companies are more costly to the public system and if the Ford government were to start charging user fees for home care, that would be a financial burden Groves and his wife would not be able to budget for.”

So, again, we see nothing in this bill to prevent private companies from taking over public home care services without governance, without any public accountability structure and without public interest protections.

There’s nothing in this bill that will help recruit the health resource workforce our health care system desperately needs.

Home care workers were already the lowest-paid in the health sector. Bill 124 made it impossible for non-profit and public income care providers to recruit and retain staff. Home care organizations had to decrease services and expand wait-lists due to staffing pressures. Elderly people and people with frail health reported missed appointments and unmet care needs. And 12.8% of the sector’s key front-line positions—PSWs, RNs and RPNs—are currently vacant.

Home and community care services are dramatically underfunded. As a result, people cannot be discharged to go home from the hospital. Post-surgical rehab and recovery must happen in the hospital because services are not consistently available in the community and that, of course, is much more expensive.

Recently in my office, I met with front-line health care workers, including PSWs. They told me that morale is low because of how this government treats health care workers. I was shocked when they told me that PSWs in Niagara, along with other workers in the Niagara Health system, are still fighting for their $3-an-hour pandemic pay. One worker pointed out that wages are so low, they would actually make more working at Costco. Yet, this government can’t figure out why there are so many vacant positions in health care. This is another bill on the topic of health care that could have addressed this, along with other pay equity issues within the health care system.

Home Care Ontario has been advocating for this government to do more. Sue VanderBent, the CEO of Home Care Ontario, said, “We aren’t doing enough to shore up the health care system outside the hospitals,” and that “the low wages are a deterrent to both recruitment and retention of front-line staff.”

CTV News reported:

“In its pre-budget report to the province, Home Care Ontario said the vacancy rates for nurses in home care stands at 17% and personal support workers sits at 12%.

“An entry-level nurse in home care earns $11 less than the same role in a hospital....

“A personal support worker in home care makes, on average, $4.61 less per hour than one working in a hospital....

“A home care personal support worker makes, on average, $20.30 per hour. An Amazon warehouse worker earns $20.37 per hour and a cashier at Cosco earns $19.87 per hour.”

The report goes on to say, “Our research indicates that a 10% increase in PSW wages would add 1,265 PSWs to the home care workforce, while a matching increase for nurses and therapists would have a similarly significant positive impact on recruitment and retention efforts going forward.” Yet, the bill before us today does none of that.

This bill does not even guarantee that Ontario Health and Ontario Health atHome workers will be unionized and full-time or full-time-equivalent workers with benefits. There’s nothing in this bill preventing Ontario Health atHome from contracting services to a temporary nursing agency rather than a home and community care agency. Provider organizations must be prevented from using temporary agency workers and mandated to use full-time or full-time-equivalent unionized workers.

This bill does not specify that the health service providers that receive contracts must be non-profit. This will allow for-profit companies to take over the home and community care sector. So again, this bill does nothing to help recruit the health human resource workforce needed to sustain our health care system.

How can the people of Ontario trust this government when they promise to fix home care when they still have not fulfilled their promise from five years ago to resolve hallway health care? In my riding, the Welland hospital recently lost its after-hours emergency surgical services. The Port Colborne urgent care, along with the Fort Erie urgent care, lost its overnight services. Both are slated to close in 2028.

Recently, I held a town hall in Port Colborne pertaining to the closure of urgent care hours. We had many folks share their experiences with the Port Colborne urgent care and the recent changes made to their hours. One resident of Port Colborne shared that they “rely on the urgent care for their primary care,” and that “53% of residents do not have a primary care physician” in Port Colborne. This shows that there’s a health care crisis on our hands, and that many folks do not have regular access to adequate health care.

Another Port Colborne resident, who preferred to remain anonymous, shared that they and many other people close to them have resourced what is known as “hospital shopping,” going from hospital to hospital in the hopes that they’ll be able to see them in a shorter period of time for their health concerns.

Another resident, Leanne, pointed out that our riding has a rapidly aging population and that the health care crisis in Niagara Centre will exacerbate the effects on seniors, some of whom are unable to drive, or require the means to get to a hospital, or when urgent cares are closed—which they are for 12 hours of the day now in my riding—or after hours of their primary care physician. How can this government commit to home care when they have failed to commit to basic health care?

This government is not suited to fix the health care crisis. Neither is it their priority. How are they going to promise my constituents that they will have access to home care if they do not have access to regular health care? There are local hospitals that run over 100% maximum capacity and have limited hours for emergency surgery. The Port Colborne and Fort Erie urgent cares are now only available to accept patients from 10 a.m. to 8 p.m. daily, as if people choose when to have an emergency. They’re also deprived of access to a family physician. My constituents and the people of Ontario need to have these health care issues addressed before they can believe that this government is going to provide proper care.

Speaker, the Ontario NDP caucus will not be supporting this legislation because it is clear our health care and home care system is broken, and this bill is another missed opportunity by this government. It fails to address the crucial issues impacting our home and health care services. The Ontario NDP official opposition has long been calling for a one-billion-dollar investment into home care, investing in new, reliable, expanded services, a $400 monthly caregiver benefit. Sadly, we see none of that in this bill.

Furthermore, this bill fails to prevent private companies from taking over public home care services or any accountability structure. PSWs, along with other workers in the Niagara Health system and across Ontario, are still fighting for their $3 pandemic pay. This government needs to treat health care workers with respect, and that starts with paying them what they deserve.

Good morning. Let us pray.

Prayers.

Resuming the debate adjourned on October 23, 2023, on the motion for second reading of the following bill:

Bill 135, An Act to amend the Connecting Care Act, 2019 with respect to home and community care services and health governance and to make related amendments to other Acts / Projet de loi 135, Loi modifiant la Loi de 2019 pour des soins interconnectés en ce qui concerne les services de soins à domicile et en milieu communautaire et la gouvernance de la santé et apportant des modifications connexes à d’autres lois.

We’ll go to questions.

As MPP for London West, one of the things I hear about most from constituents is around the home care that they receive. Either they don’t get enough hours allocated; there’s a revolving door of PSWs who don’t show up; they don’t get enough notification of when the visit is going to be. I also hear from PSWs who are constantly frustrated by their inability to provide the care and support that they were trained to provide. They are underpaid, overworked and certainly very much undervalued.

We understand the problems with this government’s approach to home care. I wondered if the member could elaborate a little bit about what an NDP government would do to improve home care in Ontario.

The Convenient Care at Home Act, 2023, if passed, could consolidate the 14 home and community care service organizations into a single organization and make the service more convenient. Ontario is investing an additional $10.3 million in 2023-24 to support Ontario health teams to implement better ways to connect primary hospitals, home and community. With an investment of more than $124 million, Ontario health teams and other health service providers are also investing in digital and virtual care options for people in Ontario.

My question to the member is, if he said he’s not supporting this act, does he mean that he wants nothing from this bill to support his community? Yes or no?

I thank the member for his comments today. You’re talking about Bill 135 as a bill that’s teeing up our health care system for further privatization. You also mentioned that there’s a shortage of PSWs that could be partly addressed if they actually increased PSWs’ wages. You said that they would be able to attract another 1,200 PSWs into our home care system.

Do you think the people of Ontario would rather have their tax dollars invested in paying PSWs better so they have better home care, or do you think the people of Ontario would rather see $650 million invested in a mega spa at Ontario Place?

Thank you to the member for the question. It’s not going to be care close to home because the government—regardless of what they put in this bill, which is really tinkering—have not properly supported health care workers in our system. That’s the problem in our system.

In my area, it’s ridiculous to say that this is going to create care close to home because I have emergency departments shutting down hours. I have people in Port Colborne that have to drive now to Welland to find that the hospital in Welland has reduced hours, and now they have to get taken in ambulance to Niagara Falls. It’s getting worse and worse and worse. Nothing in this bill is going to make it better.

What we would do is start treating health care workers with the dignity and respect they deserve so that they stay in the system and continue to provide quality care to our constituents.

I just described what’s happening in my riding with the shutting down of emergency services, with employees that haven’t even received their pandemic pay. People are leaving for jobs in other places. That’s continuing to happen and it’s largely because of this government’s actions: Bill 124 and the way that they’ve treated workers.

They can put whatever they want in this bill to reorganize things in the health care system, but if they don’t start treating workers properly, there’s not going to be anybody there to take care of people.

I think people in Ontario are mystified. When they look at what’s happening in their own community—and we’ve heard of people from Minden and other places whose emergency departments have been shut down—and then they see $8.3 billion boondoggles, they see private spas being built, they see this lavish spending and trips to Las Vegas; and here in their community their emergency department is shutting down. Clearly something doesn’t add up there. I think people are increasingly growing frustrated and are befuddled by this government’s lack of priorities.

The goal of this bill is to amalgamate the existing local health networks to become the service organization, Ontario Health atHome, Over time, a gradual transition, it will be through the Ontario health teams, of which we have 57 approved in this province that are in strategic locations across this province, servicing Ontarians. What’s going to happen is we are going to go from a system that has been fragmented, where there has been inconsistency of service; timeliness of service has not been there. We’re going to get it to the point where it will be one service provider and then managing it through these 57 approved OHTs. So it’s going to be care close to home.

My question to the member opposite: Do you not agree that we cannot stay with the status quo, and by doing this with this bill, we are going to get home care to your constituents and my constituents faster?

But, to this bill: This bill is all about the fragmented system that we currently have in providing home care. That is why we are making this legislative change, to put it into one Ontario Health atHome. Back to my question from earlier: Why is the status quo of a fragmented system and going to a coordinated system—why would you not want to break the status quo and come with us and vote for this bill?

Thank you to the member for the question. Look, they can put whatever they want in this bill. They can talk about a fragmented system, but if there’s nobody to work in the system, we’re not going to have health care. We can have this discussion all day long. They can talk about, you know, any kind of changes to the organization that they want to make, but they’ve treated health care workers terribly. They are coming into my office—haven’t even received pandemic pay, for goodness’ sake. They’re leaving the system, because they’re being treated badly.

So you can make whatever changes you want in this bill; if you don’t start treating workers properly, they will continue to leave and our health care system will continue to deteriorate.

She’s absolutely correct. Institutional care costs so much more than home care. It’s a real puzzle to us why this government, if they really want to save money, if they really want to provide better care, don’t provide better care in people’s homes much more cost-efficiently, rather than—

Madam Speaker, good morning. I’m proud to rise today to support Bill 135, Convenient Care at Home Act.

Before I address the bill, I just want to say that the fearmongering that’s coming from the opposition yesterday and continuing today—no wonder that some of our young people are questioning whether a career in health care is the right one. Because if you sit on that side of the House, it’s doom and gloom, but on this side of the House, we have some good news. Madam Speaker, you know what the good news is? That last year we had a record number of nursing students enrolled to become nurses in Ontario—30,000 nursing students, under the leadership of this government and this Minister of Colleges and Universities.

Under the leadership of this government, we allowed colleges to offer stand-alone baccalaureate programs such that just down the street from here, in an NDP riding, we have a francophone college for the first time that will be training French-language nurses right here in downtown Toronto. That is under the leadership of our government.

We have added 12,000 internationally trained nurses into the system, just last year. So despite what the opposition is saying, which is completely lacking of statistics, we on this side of the House have the numbers to show for it. In terms of PSWs, PSWs are our respected partners in care.

You know, when I was a nursing student, I trained with PSWs. I’ve learned from them, and even now when I deliver care, I often rely on the support from PSWs. They’re knowledgeable. They’re skilled and they’re part of our health care workforce.

Guess what, Madam Speaker? We have invested, into the accelerated program, into the training of 16,000 PSWs since we took office. That is a record number. I don’t know where that NDP math is coming from, but here on this side of the House, we have the numbers to support what we’re doing. I’m so proud to be part of this government, which is transforming the way we deliver health care in the province of Ontario.

So let’s talk about home care. Already, new models of home care delivery are being implemented to enable a more integrated experience for clients and their families, from the Children’s Hospital of Eastern Ontario in Ottawa, to Newmarket, to the University Health Network right here in Toronto, to local Ontario health teams. But we know that there is more work to do to ensure our loved ones have access to care they deserve in their home, when they need it.

The Convenient Care at Home Act is a game-changer. This act, if passed, will mean that patients and families will see real, tangible improvements in how home care is delivered. But don’t just take my word for it.

Sandra Ketchen, president and CEO of Spectrum Health Care had this to say: “Today’s announcement is an important step in modernizing Ontario’s home care system. We look forward to continuing to work together to provide the best possible care to patients, in the comfort of their homes.”

And Matt Anderson, president and CEO of Ontario Health, said, “This ‘connected care’ approach, and the provincial investments to support it, will help transform health care delivery and support the vision of all Ontarians having full access to the care they need, across the spectrum of health care—all working together to deliver integrated care, through their Ontario health team.”

Our health system partners know that changes are needed and that the status quo is simply not working. We will continue to engage with our partners across the home care sector to support this much-needed modernization.

And our constituents, the reason we all wake up every morning and show up here at work—I wake up at 5 a.m.; I’m sure a lot of the members here do too. They are the reason why we come to this place and why we work so hard, and they have told us that we need to transform home care, to centre home care around the patient.

For example, in my riding of Mississauga Centre, I have a beautiful co-op housing—it’s called Camille’s Place. A lot of seniors live at Camille’s Place. I recently hosted a Thanksgiving lunch with the seniors, and they told me that they have concerns with how home care is delivered—PSWs do not always show up as scheduled—and that a change is needed, and that it has to be more localized in the community and more responsive to their needs. But I also heard so many positive stories, just chatting with the ladies over some turkey. They told me that their PSWs have become a part of their family. They show up day in and day out, respond to their needs, and over time they have become family members.

Again, this goes to show how indispensable the PSWs who work in our system are. They are part of our communities, and that’s why they need to be embedded locally into our Ontario health teams—instead of this fragmented approach that we are currently seeing.

It is so important to ensure our seniors have access to dignified, compassionate care as they age, close to their loved ones and community. Our seniors built our communities, our province and our country, and it is imperative that we take care of them. They have done their job; now it is time that we do ours. Our government is continuing to invest in services for our seniors as well as their families and caregivers.

I would like to speak a little bit about my private member’s bill that I introduced, together with the member from Thornhill, Bill 121, Improving Dementia Care in Ontario Act, because it is kind of related. We’re doing the hard work to support those living with dementia. A lot of those living with dementia, of course, need home care. That is why we have to have an all-government approach and all-government strategy to work with persons living with dementia, whether they are in their home, whether they are in a long-term-care facility, or whether they happen to be in the hospital. So, in the 2022 budget, the government announced a $15-million investment over three years towards Ontario’s Dementia Strategy, to expand community-based dementia services such as home care or day programs. And in 2022-23, the ministry allocated the first $5-million installment of the $15-million investment towards initiatives that reduce patient flow from hospital to a more appropriate care setting.

I had the opportunity to visit a hospital, Brantford General Hospital, where they have done something new, something innovative, something out of the box. What did they do? Well, they invited dementia care specialists into their emergency department. So any patients who are coming into the ER for only dementia-related symptoms actually get seen by these dementia care specialists. They are not admitted to the hospital, because we know that patients with dementia do not do well if they are admitted to the hospital, because it is not a place that is conducive to them getting better. So these patients are being held overnight in the ER, then they are assessed by the dementia specialist and they’re actually referred to services back into the community. What does this do?

(1) It reduces admission rates so those beds that are critically needed for critically ill patients are not occupied by patients who actually don’t have to be there.

(2) It provides better care for the patient themself and their family.

(3) It reduces the amount of cost.

So that is exactly the kind of solution that we need to look for with our partners, because the government doesn’t have all the solutions. We need to work with our partners and local communities like the Brantford General Hospital to bring forward innovative ideas to address some of the challenges that we are facing in home care.

These innovative initiatives specifically focused on expanding dementia-related admission diversion and discharge supports, such as behavioural support programs and programs delivered by Alzheimer Society of Ontario chapters. Investments in these initiatives were identified through the government’s ALC—which is alternate level of care—five-point plan.

I originally prepared a speech for 20 minutes, but since I only have 10 minutes, I will fly through some of these things. In 2023-24, the ministry expanded community-based programs through increased investment in the ASO First Link program and GeriMedRisk. The Convenient Care at Home Act builds on our work to date to ensure Ontarian seniors can remain at home if they wish. Our government is making a historic $1-billion investment into home care, which will help to stabilize and expand this vital sector for years to come.

I know I’m not the first to say this, but the only thing better than having care close to home is actually having care in your home. People don’t want to be institutionalized unless they have really complex health care needs and, at that point, they do need to move into our long-term care facilities. But it is really critical that we help expand the sector and localize it within our Ontario health teams because people prefer to stay at home. Actually, research shows that people who are at home with the right supports have a much better quality of life, and so that’s exactly the hard work that we are doing through Bill 135, the Convenient Care at Home Act.

I really wish that the opposition would get on board and finally support these initiatives because we need a whole-of-government approach, but I’m not hearing any solutions coming from that side of the House.

One last question? The member for Ottawa Centre.

Moving on to further debate, recognizing the member for Mississauga Centre.

Ottawa West–Nepean.

Thank you to the member for—I want to get this riding name correct—Niagara Centre for those wise remarks on this bill.

Earlier this month, Seniors for Social Action released a report looking at the shortcomings of our home and community care system in Ontario, which they say is driving more seniors to actually consider MAID. One of the observances they make in that report is that the Ontario government provides six times as much funding for institutional care as they do for home care.

I know many of the home and community care organizations in my riding are reeling from the lack of funding and have been begging for funding from this government to actually be able to keep their doors open.

So my question to the member is, why doesn’t this government fund home care like it actually matters?

No further business.

We’ll move to questions.

Ms. Jones, Dufferin–Caledon, has moved second reading of Bill 135, An Act to amend the Connecting Care Act, 2019 with respect to home and community care services and health governance and to make related amendments to other Acts.

Is it the pleasure of the House that the motion carry?

All those in favour of the motion, please say “aye.”

All those opposed, please say “nay.”

In my opinion, the ayes have it.

A recorded vote being required, it will be deferred until the next instance of deferred votes.

Second reading vote deferred.

The House recessed from 0944 to 1015.

To our member from Mississauga Centre: I think you are aware that in the past 15 years, the joint force of the NDP and Liberals worked so hard to destroy our health system. Now we are rebuilding it, taking care of the well-being of Ontarians, so now they are putting up obstacles after obstacles after obstacles.

I know that you still have a lot of good news to share, as you are a first-hand member of health care. Can you share more about how this bill, Bill 135, will serve Ontarians?

The members on this side of the House have pointed out some of the problems with the government’s bill, but the biggest problem really is that it fails to address the real root cause of the health care crisis we have before us, which is a health care workforce that is not able to meet the demands of the people of Ontario.

We heard the member talk about all the nurses and PSWs who are going into our college and university system. However, when they graduate, they are moving into roles where they are not supported, they are in high-pressure-cooker environments and they are leaving. They’re leaving Ontario because the wages are too low. They’re leaving the profession because the demands are too high.

Can the member tell us why this bill did not do anything to address the health human resources crisis that we are facing in this province?

It was very good to hear my friend from Mississauga Centre speak this morning about this great bill. I think probably the greatest thing about this job is the great people you get to meet, and being able to listen to someone who has been on the front lines of health care her entire career and continues to serve where she can and when she can is absolutely amazing.

Rather than calling the progress we’ve made in hiring nurses, in building hospitals and committing millions and millions of dollars to home care, “tinkering,” we’re actually getting stuff done. Constituents in my riding have told me how important it is for them that they are able to stay in their home and in their community as long as possible as they age.

I was hoping the member could tell us a little bit more about how important this is and how this bill will ensure that seniors from my community, and indeed across Ontario, are able to age in place.

This government keeps talking about privatizing health care. They call it “innovation,” but it’s privatization. You just talked about some hospital projects that are being built, but they’re being built through P3s, which cost the taxpayer an additional 28%, according to the Auditor General.

You’re talking about this bill. It’s teeing up our home care system for privatization so that a portion of our tax dollars will be going into private, for-profit corporations rather than directly into care. You keep talking about numbers, but we have a crisis in our health care system in the province, and I’ll give you one number. We have 500 emergency room closures just from January to August of this year, and you’ve closed the Minden ER permanently. Why is this government not investing in public, not-for-profit health care and actually fixing the system? Why are you creating a crisis in our public health care system in order to privatize it and to shovel more of our tax dollars into corporate profits?

I rise today, in all honesty, to brag about the amazing folks and the community members in my riding of Hastings–Lennox and Addington. I recently had the opportunity to join in a wonderful celebration. The Lennox and Addington County General Hospital has had a volunteer service that has been active for 60 years now. The general public may not realize it, but these volunteers provide an amazing addition to our health care services. While these people might not put a cast on your arm or deliver a baby, they do provide an added level of care and comfort for the people at the hospital.

For six decades, they have been helping people find their way around the hospital. They have been providing a coffee or a quick bite to eat in the cafe and making get-well cards and small gifts available for the visitors. I, along with the hospital CEO and hospital board chair, had the chance to tell these volunteers just how grateful we are for what they bring to our local health care.

In celebration of that 60 years of service, the organization donated another $60,000 to the hospital foundation. And that’s on top of the millions that they’ve raised over that 60 years.

My thanks go to all of the volunteers and the members of that organization, and to their president, Marg Isbester, for inviting me to join in that celebration.

Thank you to the member from Mississauga Centre for her great remarks this morning. In 2018, our government was elected on a promise to invest in health care in this province and end hallway health care in our hospitals, because under the previous 15 years of the Liberal government, supported by the NDP, they failed our health care system miserably.

My question to the member from Mississauga Centre is, how does this legislation fit in with our government’s broader strategy to really support Ontarians and provide them with the health care they need, when and where they need it?